…from maternity to motherhood

Inducing labour..what to expect

It is quite common that women will choose to be induced to help get their labour started, which in those instances where the mother and baby have an underlying medical reason to be induced, it is perfectly understandable. But it is for all those women who for whatever reason feel pressurised into having one, which I want to talk about in this post.

It is not unusual for a mum-to-be to be given and induction date in her final ante-natal appointment at around 40 weeks. Yet it seems crazy that in an over-stretched NHS system that this would automatically be assumed, just because the pregnancy is lasting a little longer than anticipated. This ‘par for the course’ attitude puts women in a different mind-set and makes them think that something is ‘wrong’ with them for being ‘late’ and that perhaps something should be ‘done’.

Let’s make no mistake, being induced can, in some instances result, in a perfectly happy labour, but in some other instances, labour can go on for a long time, and can instigate what is known as the cascade of interventions.

Imagine this scenario…

A mother has become anxious that she is ‘late’ and therefore agrees to have a membrane sweep. The mother will go home and sit in anticipation, waiting for labour to start. It doesn’t, so at the next appointment the caregiver may offer a second sweep. This too doesn’t work. So they then get booked in for an induction.

This will start with a gel or pessary, called Prostaglandin, which is inserted into the vagina. Prostaglandin can cause strong contractions quickly, and can make it harder for the baby; therefore mum and baby will need to be monitored closely. If close monitoring is required, this would limit the abilty to move around (which can help progress labour). There are side effects to Prostaglandin, such as nausea, diarrhoea, foetal distress, increased need for pain relief later in labour*.

The next intervention is the Artificial Rupture of the Membranes (ARM), which can only be performed when the woman’s cervix is ripe enough. Here the amniotic sac is broken using a long flat amnihook. Breaking the waters can cause the baby distress, so your midwives will be carefully monitoring your baby for signs of distress. Other risks, at this stage, include introducing an infection or cord prolapse (when the umbilical cord drops in front of the baby’s head)*.

At this point, your caregivers will wait a couple of hours to see if labour becomes established.

Should it not, then an intravenous synthetic oxytocin drip will be inserted. If synthetic oxytocin does produce contractions, they can become much stronger and more painful, more quickly than the contractions of a spontaneous natural labour. The risks of synthetic oxytocin are similar to that of Prostaglandin, as well as a reduction of oxygen to the baby and uterine ruptures*.

If the induction is successful, and labour progresses well, then the baby will be born as usual.

However, in some instances, labour may not progress and many hours may pass. A mother may not be able to take the toll on her body and will then request an epidural to help relieve the pain. This may then require additional help delivering the baby with ventouse or forceps, because in some cases the mother doesn’t have the strength to ‘push’ the baby out.

The final intervention, which can happen at any stage – should the mother or baby be in distress, is an emergency C-section. This operation should not be taken lightly, just because it is performed regularly. It is a major operation, with a long recovery time…yet there is no luxury with a newborn of resting in bed for six weeks.

To many, this post may seem harsh, and the truth is induction can be a harsh and intense experience for both the mum and baby.

This post has been written with the facts in place, but with a personal angle, in that I encourage mums-to-be not to enter lightly into an induction when medically there are no concerns for you and your baby. I know all too well how long those last few weeks of labour feel and that everyone and their brother are asking your if there’s ‘any news?’ But your baby will arrive, your body has spent nine months growing your baby from a tiny little embryo…have faith that your body can deliver your baby naturally and with minimal intervention.